Decision to widen access to influenza vaccine
We are widening access to influenza vaccine from 1 July 2022.
What we’re doing
We're pleased to announce that we are widening access to influenza vaccine from 1 July 2022 for two new groups:
- children who are 3-12 years of age, for the duration of the 2022 calendar year
- people with serious mental health conditions or addiction, for 2022 and future years.
Why we’re widening access
In March 2022 we consulted on a proposal, and subsequently made a decision, to widen access to influenza vaccine for Māori and Pacific peoples from 55 to 64 years of age. In response to consultation on the proposal, we received many responses suggesting that we should also widen access to a range of other groups, including children under 5 years, school aged children, and people with serious mental health conditions or addiction.
These previous consultation responses are summarised in the notification of that decision.
We have been working closely with the Ministry of Health and Interim Health New Zealand monitoring uptake to scope possible options for further widened access to flu vaccine for the 2022 season, in the context of the heightened risk due to the COVID-19 pandemic. Through this work and the clinical advice we have received, we have identified that we have enough vaccine stock to widen access for children who are 3-12 years of age and people with serious mental health conditions or addiction.
We would not usually make a change to access criteria for influenza vaccine part way through the influenza season (1 July 2022). However, we have worked with the contracted vaccine supplier to ensure that two million doses would be available for the 2022 season, to allow for high uptake due to the heightened risk of severe illness from influenza, and to reduce hospitalisations during a period when the health sector is under additional pressure managing COVID-19 cases and influenza admissions. As of 16 June 2022, approximately 1.4 million doses of influenza vaccine have been distributed, but only about 1 million (half the total number of doses) have been used. We expect there could be approximately 400,000 doses that would not be used by the end of the season.
Children 3-12 years of age
Widened access is expected to reduce the impact of influenza for these children this year, and also reduce the spread of influenza to their whānau, who may be at risk from influenza themselves, during the current COVID-19 pandemic. We estimate that approximately 650,000 children from 3-12 years of age would be able receive funded influenza vaccine for this one year, and that there could be approximately 55% uptake.
Our clinical advisors have told us that immunising school age and younger children can not only protect them during the influenza season this year, but can also protect their family, whānau and community, as children easily spread influenza to others, some of whom may be at higher risk from influenza.
Tamariki under 9 years of age who have not previously received flu vaccine will need two doses given four weeks apart to gain full immunity for 2022.
Widened access for this group of people is in the context of increased risk of poor outcomes related to reduced immunity to influenza due to public health measures to manage COVID-19.
People with serious mental health conditions or addiction
We are also widening access from 1 July 2022, for both this year and then for all future years, for people with serious mental health conditions or addiction. This is to reduce the impact of influenza on a population who are at higher risk of having poorer health outcomes from the infection. We estimate that 175,000 people with serious mental health conditions or addiction would be able to receive funded influenza vaccine.
In August 2021 the Immunisation Advisory Committee recommended that eligibility for influenza vaccine be widened for people with serious mental health conditions or addiction, with a medium priority.
Our clinical advisors have told us that people with serious mental health conditions or addiction have a significant health need in relation to influenza vaccine. They typically have low influenza vaccination rates and are at risk of poor outcomes such as hospitalisation from vaccine preventable diseases.
This widened access will also benefit Māori, who experience higher rates of mental illness, higher rates of suicide and greater prevalence of addictions than the wider population.
Primary health sector
Our clinical advisors have previously told us that widened influenza vaccine started mid-season could place additional strain on the primary health sector, which is already busy managing COVID-19 cases in the community. The Ministry of Health is responsible for supporting the implementation of changes to the National Immunisation Schedule and has advised us there is work underway to help manage the workload in this busy time. We also expect that any reductions in the community-wide incidence of influenza infection, via reduced spread from children to others, may have a flow-on benefit for primary care through decreased community influenza disease burden.
Who we think will be most interested
- Caregivers and whānau of children 3-12 years of age
- People with serious mental health or addiction, their whānau and caregivers
- Doctors in general practice, pharmacists, nurses and vaccinators
- DHBs
- Suppliers and wholesalers
- Organisations with an interest in child health
- Organisations with an interest in mental health
- Organisations with an interest in immunisation
Detail about this decision
From 1 July 2022, funded access to influenza vaccine will be widened to include children from 3-12 years of age for the 2022 calendar year, and people with serious mental health conditions or addiction for 2022 and future years.
The following changes to influenza vaccine eligibility criteria will occur in Section I of the Pharmaceutical Schedule (additions in bold):
- INFLUENZA VACCINE – people 3 years and over
is available each year for patients aged 3 years and over who meet the following criteria, as set by Pharmac:- all people 65 years of age and over; or
- people 55 to 64 years of age (inclusive) who are Māori or any Pacific ethnicity; or
- people under 65 years of age who:
- have any of the following cardiovascular diseases:
- ischaemic heart disease, or
- congestive heart failure, or
- rheumatic heart disease, or
- congenital heart disease, or
- cerebro-vascular disease; or
- have either of the following chronic respiratory diseases:
- asthma, if on a regular preventative therapy, or
- other chronic respiratory disease with impaired lung function; or
- have diabetes; or
- have chronic renal disease; or
- have any cancer, excluding basal and squamous skin cancers if not invasive; or
- have any of the following other conditions:
- autoimmune disease, or
- immune suppression or immune deficiency, or
- HIV, or
- transplant recipients, or
- neuromuscular and CNS diseases/disorders, or
- haemoglobinopathies, or
- are children on long term aspirin, or
- have a cochlear implant, or
- errors of metabolism at risk of major metabolic decompensation, or
- pre and post splenectomy, or
- down syndrome, or
- are pregnant; or
- have any of the following cardiovascular diseases:
- children 3 and 4 years of age (inclusive) who have been hospitalised for respiratory illness or have a history of significant respiratory illness; or
- people under 65 years of age who:
i) have any of the following serious mental health conditions:
a. schizophrenia; or
b. major depressive disorder; or
c. bipolar disorder; or
d. schizoaffective disorder; or
ii) are currently accessing secondary or tertiary mental health and addiction services; or - children 3 to 12 years of age (inclusive), from 1 July 2022 to 31 December 2022;
Unless meeting the criteria set out above, the following conditions are excluded from funding:
a. asthma not requiring regular preventative therapy,
b. hypertension and/or dyslipidaemia without evidence of end-organ disease.
2. Contractors will be entitled to claim payment from the Funder for the supply of influenza vaccine to patients eligible under the above criteria pursuant to their contract with their DHB for subsidised immunisation, and they may only do so in respect of the influenza vaccine listed in the Pharmaceutical Schedule.
3. Contractors may only claim for patient populations within the criteria that are covered by their contract, which may be a sub-set of the population described in paragraph A above.
The following changes will be made to Part II of Section H of the Pharmaceutical Schedule (additions in bold, only new criteria shown):
Initiation – Serious mental health conditions or addiction
Any of the following:
- schizophrenia; or
- major depressive disorder; or
- bipolar disorder; or
- schizoaffective disorder; or
- person is currently accessing secondary or tertiary mental health and addiction services.
Initiation – children from 3 to 12 years of age (inclusive)
Children 3 to 12 years of age (inclusive) from 1 July 2022 to 31 December 2022.
Implementation of changes to the National Immunisation Schedule
The Ministry of Health has told us it supports widening of influenza eligibility for the 2022 season. The National Immunisation Programme will work with the sector, including pharmacy, to communicate the eligibility change. Recent amendments to the Medicines Regulations 1984 mean that pharmacists can vaccinate people from 3 years of age and older. It is expected that pharmacists will be a key provider for vaccinating people who meet the widened criteria. The National Immunisation Programme will also work with the Ministry of Health’s Mental Health and Addiction Directorate to provide support and ensure eligible people can access the funded influenza vaccine.
About influenza vaccine
Influenza can be a serious illness that is sometimes fatal. Infection with the influenza virus may lead to a stay in hospital for people of any age, but particularly if you are elderly or have an ongoing medical condition. Influenza can worsen existing medical conditions such as asthma or diabetes.
Influenza vaccine is funded each year for a range of people, including those 65 years and older, in pregnancy, and for people with medical conditions such as heart disease, respiratory conditions, diabetes, renal disease, and autoimmune diseases. Over 1.4 million people are usually vaccinated annually (funded and privately purchased).
The Afluria Quad and Afluria Quad Junior are the only funded influenza vaccines for the 2022 season and this decision relates to only the Afluria Quad vaccine. It is a quadrivalent vaccine, which means it protects against four strains of influenza virus. For the 2022 season, the strains included are: A/Victoria, A/Darwin, B/Austria and B/Phuket.
If you have any questions about this decision, you can email us at enquiry@pharmac.govt.nz; or call our toll free number (9 am to 5 pm, Monday to Friday) on 0800 660 050.